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UK malaria treatment guidelines

Author(s)David G. Lalloo; Delane Shingadia; Geoffrey Pasvol; Peter L. Chiodini; Christopher J. Whitty; Nicholas J. Beeching; David R. Hill; David A. Warrell and Barbara A. Bannister; for the HPA
Advisory Committee on Malaria Prevention in UK Travellers
AbstractMalaria is the tropical disease most commonly imported into the UK, with 1500 - 2000 cases reported each year, and 10 - 20 deaths. Approximately three-quarters of reported malaria cases in the UK are caused by Plasmodium falciparum, which is capable of invading a high proportion of red blood cells and rapidly leading to severe or life-threatening multi-organ disease.

Management of malaria depends on awareness of the diagnosis and on performing the
correct diagnostic tests: the diagnosis cannot be excluded until 3 blood specimens have been
examined by an experienced microscopist.

The treatment of choice for non-falciparum malaria is a 3-day course of oral chloroquine, to which only a limited proportion of P. vivax strains have gained resistance. ALL patients treated for P. falciparum malaria should be admitted to hospital for at least 24 h, since patients can deteriorate suddenly, especially early in the course of treatment.

Falciparum malaria in pregnancy is more likely to be severe and complicated: the placenta
contains high levels of parasites. Malaria in children (and sometimes in adults) may
present with misleading symptoms such as gastrointestinal features, sore throat or lower respiratory complaints; the diagnosis must always be sought in a feverish or very sick child who
has visited malaria-endemic areas.

An acute attack of malaria does not confer protection from future attacks: individuals who have had malaria should take effective anti-mosquito precautions and chemoprophylaxis during future visits to endemic areas.
Date of publishing01/26/2007
Date of last review by us01/26/2007
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